系统性红斑狼疮患者外周血滤泡辅助性T细胞和滤泡调节性T细胞表达变化及意义  

Changes in Expression and Significance of Follicular Helper T Cells and Follicular Regulatory T Cells in Peripheral Blood of Patients with Systemic Lupus Erythematosus

作　　者：安平 邢倩[1] 

机构地区：[1]青岛大学附属青岛市市立医院,山东 青岛

出　　处：《临床医学进展》2024年第4期2469-2476,共8页Advances in Clinical Medicine

摘　　要：目的:检测系统性红斑狼疮(SLE)患者外周血中滤泡辅助性T细胞(Tfh)细胞亚型和效应记忆Tfh细胞(Tfh-EM)以及滤泡调节性T细胞(Tfr)的表达,并探讨其在SLE患者发病中的临床意义。方法:流式细胞术分别检测30例SLE患者和26例健康对照的外周血中Tfh (CD4 CXCR5 )细胞亚型Tfh1 (CD4 CXCR5 CXCR3 CCR6−)、Tfh2 (CD4 CXCR5 CXCR3−CCR6−)、Tfh17 (CD4 CXCR5 CXCR3−CCR6 )、Tfh-EM (CD4 CXCR5 ICOS PD-1 )和Tfr (CD4 CD25 CXCR5 CD127low)的水平。收集入组SLE患者的临床资料及实验室指标,采用酶联免疫吸附试验(ELISA)法检测各组受试者外周血中白细胞介素21 (IL-21)。结果:SLE组与健康对照组相比,外周血中Tfh-EM细胞、Tfh17细胞、总Tfh细胞的表达和外周血中IL-21水平较健康对照组表达升高(P均 P = 0.020)。外周血Tfh-EM细胞在SLE组中高病情活动度的表达高于低疾病活动度的患者(P = 0.024)。Tfh-EM细胞与抗ds-DNA抗体存在正相关(ρ = 0.444, P = 0.018),Tfr细胞的比率与疾病活动度SLEDAI-2K评分呈负相关(ρ = −0.392, P = 0.039)。结论:SLE组Tfh表达升高致Tfh/Tfr比值失衡,Tfh-EM细胞、Tfh17表达异常可能参与了SLE的发生和发展。Objective: To investigate the expression of follicular helper T cell (Tfh) subtypes and effector memory Tfh cells (Tfh-EM) in the peripheral blood of patients with systemic lupus erythematosus (SLE), as well as the expression of follicular regulatory T cells (Tfr), and to explore their clinical significance in the onset of SLE. Methods: Flow cytometry was utilized to analyze the levels of Tfh (CD4 CXCR5 ) cell subtypes, including Tfh1 (CD4 CXCR5 CXCR3 CCR6−), Tfh2 (CD4 CXCR5 CXCR3− CCR6−), Tfh17 (CD4 CXCR5 CXCR3−CCR6 ), Tfh-EM (CD4 CXCR5 ICOS PD-1 ), and Tfr (CD4 CD25 CXCR5 CD127low) in the peripheral blood of 30 SLE patients and 26 healthy controls. Clinical data and laboratory parameters of the SLE patients were collected, and enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of interleukin-21 (IL-21) in the peripheral blood of each participant. Results: The expression of Tfh-EM cells, Tfh17 cells, total Tfh cells in peripheral blood and the level of IL-21 in peripheral blood were elevated in the SLE group compared to healthy controls (P all P = 0.020), Peripheral blood Tfh-EM cells were expressed higher in the SLE group with high disease activity than in patients with low disease activity (P = 0.024). There was a positive correlation between Tfh-EM cells and anti-ds-DNA antibodies (ρ = 0.444, P = 0.018), and the ratio of Tfr cells was negatively correlated with the SLEDAI-2K score of disease activity (ρ = −0.392, P = 0.039). Conclusion: Elevated Tfh expression in the SLE group resulted in an imbalance of the Tfh/Tfr ratio, and abnormal expression of Tfh-EM cells, Tfh17, may be involved in the occurrence and development of SLE.

关 键 词：系统性红斑狼疮 滤泡性T调节细胞 滤泡性T辅助细胞 

分 类 号：R59[医药卫生—内科学]